This Editor recounted last night in the article below on The TeleDentists’ fresh agreements with Cigna and Anthem the observation of a former associate who has been in the thick of the remote patient monitoring wars for some years that telehealth/telemedicine has progressed 10 years in 2 months. Seema Verma, the head of the Centers for Medicare and Medicaid Services (CMS), stated to the Wall Street Journal (paywalled), “I think the genie’s out of the bottle on this one. I think it’s fair to say that the advent of telehealth has been just completely accelerated, that it’s taken this crisis to push us to a new frontier, but there’s absolutely no going back.” Even in a short period of time, CMS-reported telehealth visits as of 28 March trebled from 100,000 to 300,000. When the April numbers are in, it would not be surprising to see it grow well into seven figures.

The genie may be out of the bottle, but what will the genie do? Genies are, after all, unpredictable, and fly around. Out of the smoke, some educated guesses:

Insecure, non-HIPAA compliant audio/video platforms will be the first which should be struck from CMS approval. Zoom has become a hackfest, with all sorts of alerts from mobile providers like Verizon on how to secure your phone. (An organization of which this Editor is a member had a panel this week completely disrupted by a hacker in five minutes.) Skype’s problems are well known. The winners here will be telehealth platforms that integrate well with EHRs, population health platforms (or may be part of population health platforms), and have robust security.

Primary care practices and specialists, who’ve been surviving on non-F2F visits, will be adjusting their practices to patient demand, and integrating telehealth with physical visits in a way that their patients will prefer. This means a search for integration of EMRs/EHRs with secure platforms and reconfiguring areas such as care coordination. If planned correctly, this could create better management of patients with multiple chronic conditions.

Actual physical visits will rebound, creating financial pressure on Medicare, hospitals, and private payers. How many people’s health has declined in two-three months is key. Small practices, who may see this first, will see another level of pressure, because they will be held to their Medicare quality metrics in value-based models even if adjusted. Hospitals will also rebound–if they are able. The dark side: private payers may run the numbers and scale back on benefits for the 2021 year especially if COVID is projected to make a return.

Behavioral health may benefit, yet drive individual practices and a wave of retirements, or a consolidation into clinic or group settings. There’s a reason why Optum is buying out AbleTo; we may see a wave of competitor acquisitions in this area with the emphasis will be on cognitive health and short courses. Why retirements? Many psychiatric practices are still independent, concentrated geographically, and the average psychiatrist is over 50. Psychiatric EHRs are both costly and not particularly suited to practices. If faced with technological challenges, a lot of MDs and senior clinical psychologists may very well exit–threatening clinics which need MDs to legally operate.

Rural health’s failure accelerated.USA Today’s analysis pinpointed at least 100 rural hospitals to close within the year. They already operated on thin margins, but with COVID expenses for additional equipment, the closing down of more profitable elective procedures and dependence on Medicaid, the over 1,100 unprofitable hospitals, over half of which are the only hospital in their county, have received a body blow. HHS allocated $10 billion to rural hospitals and clinics of the $100 billion aid package, but it may be too little and too late. Becker’s Hospital Review continues to track the bankruptcies and closures. Here there are no easy solutions from the digital health area.

A culture of cleanliness should accelerate. If the genie pulls this out of the bottle, one major benefit will be that hospital-acquired infections will decline. Effective sanitization methods that reduce human application and scrubbing will be the ones to look at: disinfecting foggers and UV full room or area systems–or combinations of same. Cleanliness and lack of virii and bacteria may become a new metric. Look and bet on companies that can provide this, from rooms to computers/mobile tablets and phones.

Readers can help with these prognostications and especially how they will play out not only in the US, but also in the UK, Europe, and worldwide.

From Mr. Sutherland: “The change in ownership deal is now subject to several legal steps including a European Commission review regarding Competition Law. We expect to be able to address any issues and the deal to be signed in late June/July.” Checking back on the Charterhouse website, Tunstall is still categorized as an unexited portfolio company(or ‘unrealised’ in a more delicate term).

Another reveal in this conversation is a strategic statement that segments care and presumably the company’s direction into four parts, somewhat like Roman Gaul (which was three or five, depending on the history you’re reading):

Reactive care: for instance an alarm bell or PERS press

Proactive care: reactive plus social care and well checks

Predictive care: sensor-based tracking in the home. Presumably this would be rules-based (i.e. time) on ADLs.

Tunstall has added to this Cognitive Care or “Intelli-Care” which would combine presumably #2 and #3 along with other healthcare data from the user which would be analyzed to deliver social or health ‘nudges’. While in its ‘infancy’ according to Mr. Sutherland, this type of system would also detect changes in vital signs which require intervention.

#3 and especially #4 referred to as in ‘infancy’ leave this Editor puzzled. Back in 2006-9, the QuietCare system (still sold by Care Innovations) had changes in ADLs based on a normative model baselined over two weeks pretty much nailed down. There are more advanced systems such as CarePredict that take that motion and movement and have put it on a wrist-based sensor system that is now sold for individuals at home as well as in group living–with fall prediction and a PERS for good measure. Vital signs monitoring can also be done with other personal devices, watches, and smartphone/tablet reporting, but medical grade monitoring is another step further with far more complex integration.

Part 2 of the conversation will discuss what are the anticipated changes to health and social care service sectors and the proposed strategic direction of TSA. Hat tip to one of our Readers

Updated 25 April: A further snippet on how the new investment will play out at Tunstall is found on healthcare business intel provider Laing Buisson’s Care Markets website. In their view, the Barings/M&G investment will be “supporting the restructure, which will see the business recapitalised and debt reduced to £180m….” The rest is unfortunately only available to Care Markets newsletter subscribers, of which we are not. Again, no mention of Charterhouse.

Appello announced another major acquisition to close out the year. Effective 5 December, they have acquired the home monitoring business of Medvivo, Medvivo Careline Ltd. Careline provides telecare alarm monitoring, ‘comfort calls’, and out-of-hours call monitoring services to at-home and at-risk customers. The company was formerly known as Magna Careline. Terms were not disclosed.

The Medvivo Careline acquisition increases Appello’s monitoring customers by about 20 percent to approximately 250,000. Appello’s earlier acquisition this year was of RedAssure Independent Living from Worthing Homes [TTA 17 Oct]. Appello is the UK’s largest telecare monitoring service.

Medvivo, in its statement, took some pains to position the sale as enabling the company to focus on their now core business of integrated urgent care services across Bath and NE Somerset, Swindon and Wiltshire. It demonstrates that the UK health tech area continues to consolidate, notably in the monitoring area.

Appello telecare acquires RedAssure Independent Living from Worthing Homes. A 20-year provider of telecare services to about 700 homes in the Worthing area in West Sussex, the acquisition by Appello closed on 1 October. Previously, Appello provided monitoring services for RedAssure since 2010. Terms were not disclosed. Release.

Another NHS Digital departure is Rob Shaw, deputy CEO. He will be leaving to pursue a consulting career advising foreign governments on national health and care infrastructure. He is credited with moving the NHS Spine in-house and establishing NHS Digital’s cybersecurity function. The Digital Health article times it for around Christmas. Mr. Shaw’s departure follows other high-profile executives this year such as former chief digital officer Juliet Bauer who controversially moved to Kry/LIVI after penning a glowing article about them [TTA 24 Jan], Will Smart, Matthew Swindells, and Richard Corbridge.

Babylon Health’s GP at Hand plans Manchester expansion. The formal notification will likely be this month to commissioners of plans to open a Manchester clinic as a center for GP at Hand’s primarily virtual consults. This follows on their recent expansion into Birmingham via Hammersmith and Fulham CCG which will be notified. How it will work is that patients registering in Manchester would be added initially to a single patient list for GP at Hand located at Hammersmith and Fulham CCG. Babylon is now totalling 60,000 patients through GP at Hand. GP Online

Singapore’s Verita Healthcare Group has acquired three digital health startups. The two from Singapore are nBuddy and CelliHealth, in addition to Germany’s Hanako. Verita has operations in Singapore, the US, Asia-Pacific and Europe, with 35 alliance partnerships with medical clinics and hospitals across Australia, Southeast Asia and Europe. Mobihealthnews APAC

Novant Health, a 640-location health system in North Carolina, is introducing Tyto Care’s TytoHome integrated telehealth diagnostic and consult device as part of its network service. Webpage, release

A question this Editor’s been asking since 2007, wondering why the rising tide of the market isn’t lifting the business boats. Adrian Scaife’s brief article on the TSA blog rhetorically asks the question and speculates on some answers. Mr. Scaife starts with the Care Technology Landscape Review’s [TTA 18 July] simple fact that growth in the UK has been flat for the past decade at 1.7m users nationally. Yet the demographics, social care dynamics, and the desire to live independently at home, enabled by more accessible and usable technology, should mean otherwise.

Some of the reasons why are addressed in the Care Technology report: the industry’s focus on bright shiny tech, what sells to organizations versus emerging needs–and not focusing on benefits to the end users or ‘design and delight in the way the solutions look’ (the Apple paradigm). As Mr. Scaife put it, “It is perhaps not surprising consumers are currently voting with their feet!”

What might get the feet going in the other direction? A “new generation of telecare that builds on existing services” that “delivers proactive, preventative, consumer friendly services with positive reassurance”. The difference is that this can be enabled by both “interoperable devices” (that shiny tech) but integrated with data that can provide that proactive insight. But those insights must be supported by a health and social care structure, more in place in the UK than in the US, for instance–and that may require the transformation first versus later. Why Isn’t Our TEC Industry Booming?

There must have been a moment, somewhere, when a bronze age warrior realised that iron really cut the mustard (and other things) better. Unfortunately, that resulting genetic preference for new over old has left us open to the blandishments of salespeople through the ages, encouraging us to take every opportunity to buy new and cast out old.

And it costs! A current example is the drive by many telecare companies to use the digitalisation of the telecoms network in the UK to encourage users to ditch their analogue equipment in favour of their new shiny digital kit…when there’s no need. The telecare world has of course an honourable tradition of encouraging box shifting – back when I ran a telecare programme at LB Newham, in 2007 the government was encouraged to offer a Preventive Technology Grant to all local authorities. Perhaps the most memorable campaign though was Three Million Lives which, from the outside, appeared to have that one aim. Indeed there must be few telecare consultants who have not at some point in their career opened a cupboard to find the shelves heaving with unused – and sadly in a few cases unusable – kit.

Wise telecare providers will resist the current pressures though – both BT and Virgin have been provided with a wide range of old analogue telecare kit to test in their digital simulators alongside the appropriate digital/analogue converters and, I am reliably informed, it has worked well every time. Some companies, I am told, may not have taken full advantage of these facilities and only tested their new digital offerings, whilst ignoring analogue; I’ll leave the reader to work out why they might have done that. This is important because telecare kit is built to last and whilst some service users will benefit from the latest tech wizardry, most will be completely happy with the older kit – indeed those with dementia may find it impossible to get used to any new kit, providing one more incentive not to change. The original cost of that analogue kit must conservatively be well over £500 million, so it would seem to be a crying shame just to dump it whilst it still works well – indeed with local authority budgets as they are, it effectively would hugely reduce their ability to provide a service for all who want it.

There is of course one potential issue, as no power comes down the fibre telecoms lines, unlike with copper, so the service could fail in a blackout. However I understand that both BT and Virgin are working on solutions to this. GSM alarms, supposedly the future, are also vulnerable; indeed apparently this already happened a a few weeks back when the country suffered widespread power outages, when mobile networks failed in some areas. I understand that many masts don’t currently have a power back-up for such occasions and those that do only last 30 minutes.

So, if you are responsible for a telecare provision budget and a nice salesperson pops by to encourage you to switch out your old, ask them how their old kit behaved in the network simulations when paired with an appropriate converter.

If they tell you anything other than that it went really well, look askance. If they say they haven’t tested their old kit, ask them why not.

While this Editor was on holiday, Sweden’s Doro AB increased its presence in the UK with the acquisition of Invicta Telecare, parent of Centra Pulse and Connect. Invicta’s products will join the Welbeing PERS service. which at the time of their acquisition last June had about 75-80,000 users [TTA 7 June 18].

Invicta was sold by Clarion Housing Group, the UK’s largest social housing association, which includes a property development company and a charitable foundation. Invicta’s 2018 revenue was £6.3 million. Like Welbeing, Centra Pulse offers basic and mobile PERS, but also has multi-sensor in-home connected home capability. It is also one of the top three UK monitoring services and is a major provider of after-hours contact services for telecare providers, such as housing associations and local authorities. The sale was effective on 1 September.

The UK remains the largest telecare market in the European region with an estimated 1.8 million telecare connections. It faces a transition to digital from analog systems which affects social care spending and residential service capabilities. Doro operates in the UK and about 40 countries, with a core business in mobile phones specially designed for older adults. Doro announcement, press release

In-home behavioral tracking of older adults, which was a significant portion of telecare circa 2007 up until a few years ago, may be getting a new lease on life. The technology in this round is the same as what guides self-driving vehicles–LiDAR or Light Detection and Ranging, which uses laser light pulses to map images of movement and surroundings.

In this model, IBM Research will use the LiDAR information and their machine learning to establish normal patterns and also to observe behaviors that may indicate a potentially dangerous condition or situation. The LiDAR pilot will be in 10-15 households in the UK starting in June. IBM is partnering with early-stage UK home care company Cera Care on the reporting and linking with care staff on alerts on changes in behavior that may predict a more acute condition.

Many of the privacy issues that dogged predictive behavioral telemonitoring via networked infrared motion sensors, as well as in-home cameras, are present with LiDAR monitoring. Unlike 2007, five states have ‘nanny cam’ laws that prohibit cameras within skilled nursing facilities without patient consent (Senior Housing News) Another issue: expense. LiDAR sensor setups cost up to $1,000 each, and at least one per room is needed. Far cheaper setups are available from the Editor’s long-ago former company, QuietCare, if one can still purchase them for the home from Care Innovations; Alarm.com, UK’s Hive Link, and Google may get into the act with their Nest connected home tech.

Senior housing may open up a new market for LiDAR, which is wilting in the autonomous vehicle (AV) area as it’s proven to be rather buggy on real roads with real drivers. Certainly the housing and care market is growing and destined to be huge, with over-60s growing from 900 million in 2015 to 2 billion worldwide in 2050, while for-hire caregivers are shrinking by the millions. Business Insider, Reuters

Virginia closes in on including remote patient monitoring in telehealth law. Two bills in the Virginia legislature, House Bill 1970 and Senate Bill 1221, include remote patient monitoring (RPM) within their present telehealth and telemedicine guidelines and payment in state commercial insurance and the commonwealth’s Medicaid program. It is currently moving forward in House and Senate committees with amendments and. RPM is defined as “the delivery of home health services using telecommunications technology to enhance the delivery of home health care, including monitoring of clinical patient data….” Both were filed on 9 January. Virginia was an early adopter of parity payment of telemedicine with in-person visits. The University of Virginia has been a pioneer in telehealth research and is the home for the Mid-Atlantic Telehealth Resource Center. mHealth Intelligence

Chichester Careline switches to PPP Taking Care. Chichester Careline is currently a 24/7 care line services provided by Chichester District Council. Starting 1 March, PPP Taking Care, part of AXA PPP Healthcare, will manage the service. According to the Chichester release, costs will remain the same, technology will be upgraded, and telecare services will be added. Over the past 35 years, Chichester Careline has assisted over 1 million people across Britain.

Sensyne collaborates with University of Oxford’s Big Data Institute (BDI) on chronic disease. The three-year program will use Sensyne’s artificial intelligence for research on chronic kidney disease and cardiovascular disease. Sensyne analyzes large databases of anonymized patient data in collaboration with NHS Trusts. BDI’s expertise is in population health, clinical informatics and machine learning. Their joint research will concentrate on two major elements within long-term chronic disease to derive new datasets: automating physician notes into a structure which can be analyzed by AI and integrating it into remote patient monitoring. Release.

Tunstall partners with Digital Health & Care Institute Scotland. The partnership is in the Next Generation Solutions for Healthy Ageing cluster. Digital Health & Care supports the Scottish Government’s TEC Programme and the Digital Telecare Workstream. The program’s goals are to help Scots live longer, healthier lives and also create jobs. Building Better Healthcare UK

Teledermatology powered by machine learning helps to solve a specialist shortage in São Paolo. Brazil has nationalized healthcare which has nowhere near enough specialists. São is a city with 20 million inhabitants, so large and spread out that when the aircraft crew announces that they are on approach to the airport, it takes two hours to touch the runway. The dermatology waitlist was up to 60,000 patients, each waiting 18 months to see a doctor. The solution: call every patient and instruct them to go to a doctor or nurse to take a picture of the skin condition. The photo is then analyzed and prioritized by an algorithm, with a check by dermatologists, to determine level of treatment. Thirty percent needed to see a dermatologist, only 3 percent needed a biopsy. Accuracy level is about 80 percent, and plans are in progress to scale it to the rest of Brazil. Mobihealthnews.

Canary Care, which entered administration in late August, has been reorganized and continues as Canary Care Global Ltd, remaining in Abingdon. The purchaser in the pre-packaged sale, as Readers learned here, is Lifecycle Software Ltd. Their marketing office sent a release last week confirming their operations. Stuart Butterfield, who answered our inquiries in September, is now managing and technical director. He is quoted in the release: “This is a really positive development for our company. We will continue to provide the Canary Care product and service that our existing customers know and love. Our new owner provides us with the stability and resources to further enhance the Canary Care offering and we’re very excited and optimistic about the future and the opportunity to bring Canary Care to a wider audience.”

The administrator’s latest filing with Companies House is clearly a wrapup of the sale as the best possible outcome for the company. Shareholders included major investor Mercia Fund Management. A quick read of the administrator’s proposal is an object lesson how quickly an insolvency can happen. In section 2, the company went from seeking fresh funding to expand markets in May, having been turned down by Mercia due to their funding criteria, to having an interested buyer who ultimately was not approved by the shareholders by a hairsbreadth, to insolvency by August.

We do wish Canary Care luck with their new ownership and success in this very difficult time for acceptance of –and payment for–telecare and TECS services. Release (PDF) Hat tip to Nicola Hughes of Lifecycle Software

This conference aims to support health and social care organisations that are looking to undertake large-scale digital change, no matter what their current level of technological advancement. Understand the factors that contribute to successful change by showcasing the experiences of different case study sites and Global Digital Exemplars that have already made significant progress. More information and registration here.

UK Telehealthcare has several events coming up all over the country. For more information and registration, click here or the advert in the right sidebar and scroll down to ‘Members Events Coming Up’.

At the UKHT conference, over 300 delegates will hear speakers discuss the major strategic issues and policy developments facing the life science and healthcare sectors. Showcases include the latest advances in R&D technologies and up and coming spinout companies. It closes with the 13th annual MediWales Innovation Awards, celebrating the achievements of the NHS, life science and health technology communities in Wales. More information and registration here.

SEHTA is calling for nominees for its 2018 Healthcare Business Awardsthrough Friday 14 December. They are looking for the best achieving companies of 2018 in the following five categories: Export Achievement, Start-up, Innovation, Partnership with the NHS
MedTech, and the new category of Healthcare Investment of the Year (most significant/transformational public and/or private sector funding received in 2018). To download application forms, click here. Completed forms should be returned to Clare Ansett – clare.ansett@sehta.co.uk

Mr. Paul Dixon has taken advantage of our open offer to Readers who are available to lend their talents to new or established companies in the healthcare or healthcare tech field.

I am a “tech-savvy” and experienced user training professional with extensive experience in providing training in a broad range of contexts and environments. I am specifically experienced in security, social alarm and telecare control rooms. As I also have a background in management and leadership, one of my key differentiators is that I focus on behavioural change in staff, not just on “mechanical” user processes.

In addition to training, I can create a full range of user-focused training materials.

Two international telecare/telehealth/telemedicine M&A deals made the news this last week.

Sweden’s Doro AB acquired Welbeing, headquartered in Eastbourne UK. Welbeing (formally Wealden and Eastbourne Lifeline) is a telecare provider of home-based personal alarms which supports about 75,000 residents in local systems. Their revenue in last fiscal year (ending 9/17) was £7.6 million (SEK 90m). Doro operates in the UK and about 40 countries, with a core business in mobile phones specially designed for older adults. Their Doro Care solutions provide digital telecare and social services for older adults and the disabled in the home. Doro is paying SEK 130 million (£11.1 million) for the acquisition of Welbeing, equal to eight times estimated EBITDA for the financial year 2017/2018, with 85 percent cash and 15 percent in Doro shares with a bonus based on financial performance. Release

Making a few headlines in the US is telemedicine leader Teladoc’s purchase of Barcelona’s Advance Medical for a hefty $352 million, giving Teladoc a major international footprint especially valuable for its corporate clients and major payers. Advance Medical provides complete telemedicine services in 125 countries in over 20 languages. Even more valuable is their knowledge of local healthcare delivery systems, global expert medical opinion, and chronic care. The acquisition also gives Teladoc an international network of offices and a significant entreé with international health insurance companies. Mobihealthnews, Seeking Alpha (Teladoc investor slideshow)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”100″ /]NHS Digital CCIO doesn’t like ‘shiny objects’. Dr. Simon Eccles used his first NHS Digital board meeting as national CCIO to encourage delivering the current agenda first and not getting distracted by the ‘shiny objects’ of new innovations which also divert funding. “It is our collective challenge to make sure that doesn’t happen to things that are valued by the NHS – to do what we said we’d do and not be too distracted by new and shiny things.” This seems to be at odds with non-executive director Daniel Benton, who “suggested that NHS Digital needed to become more flexible as an organisation so that it was in a better position to roll with the punches in future.” Digital Health News

Docobo announced their win of the NHS Liverpool Clinical Commissioning Group‘s scale up of telehealth as part of the Healthy Liverpool program. The three to five-year contract has a maximum value of £11.5 million. The current Mi Programme (More Independent) partly funded by the Innovate UK dallas initiative and using Philips equipment is at 900 patients with 5,300 total patients since 2013. The plan is to scale up the program to 4-5,000 patients a year and support new clinical pathways and conditions including lung conditions, heart failure, and diabetes. Docobo’s platform is Doc@Home which uses patient information from the CarePortal device or their own digital devices. Docobo release. NHS Innovation Accelerator, Digital Health News

A survey of 500 British adults conducted by UK IT VAR Proband found that perceptions of public sector information security are poor. 87 percent were concerned about the security of their information with the NHS. Of that 87 percent, 34 percent were ‘very concerned’ about their cybersecurity. Taking this with a grain of salt, 80 percent distrusted security at the Driver and Vehicle Licensing Agency (DVLA) and 78 percent on data held by the police. The General Data Protection Regulation (GDPR) can’t come too soon [TTA 17 Feb] — but are you ready? More in Proband’s Online Security Audit (PDF).

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/02/Utopia-project-report-2018.jpg” thumb_width=”150″ /]An important and comprehensive evaluation of telecare in use in UK social care has been published this past week by King’s College London. The UTOPIA Project (Using Telecare for Older People In Adult social care) surveyed local authority telecare managers (114 valid responses or 75 percent of responders) November 2016-January 2017 to find out how telecare is being used by local authority adult social care departments in England to support older people.

This study springboards from the £80m Whole System Demonstrator (WSD) and its “curious neglect” by those engaged in UK telecare. The WSD’s findings contradicted earlier research in finding that telecare did not have long-term improvement of outcomes, gauged after only 12 months. It created, in the UTOPIA’s study’s terms, a ‘policy problem’ among major stakeholders. “The WSD remains an important study and its neglect is curious. The research team wondered why the findings had been overlooked and what, if any, consequences might have flowed from this.” The study thus looks at local authority aims, how local evidence is being collected, and how telecare is operationalized and delivered.

The areas surveyed and some highlights of the findings are:

Use of research: 33 percent were informed by research and 47 percent were aware of but did not agree with the WSD’s findings which were negative on the long-term value of telecare.

Where does telecare fit in?: “Telecare ‘fitted’ best if it was provided alongside social care (77%), to support reablement (77%), for people eligible for and funded by the adult social care department (75%) as well as for people who pay for their own care (75%).” Only 24 percent collaborated with the NHS or other partners. There was full (100 percent) agreement that telecare helps to reduce risk and promote safety and 81 percent agreement that it supports unpaid carers.

Achieving strategic aims and monitoring of progress: Over half (53 percent) of respondents said their local authority was accredited to the Telecare Services Association (TSA) Codes of Practice for Telecare and Telehealth.

Barriers and facilitators: Barriers mentioned were skill deficits among professionals and installers, as well as contract inflexibility with suppliers. There was also concern about the reduction of face-to-face contact and care. Access to telecare and availability of advice and support were good for both users and family carers, but levels of awareness about it were only average.

Financial commitment: Not surprisingly, funding is scarce and usually cobbled together from several sources including local authorities, CCGs, and users. 24 percent felt it saved money but many found it difficult to provide hard evidence.

What’s considered in telecare assessments?: Nearly all (92 percent) agreed that a key assessment included the user’s ability to move around, their memory status, the person’s ability to communicate, and their daily routines. Flipping the script, “40% of respondents said that their local authority’s telecare assessment focused on what it was hoped would be achieved through using telecare.”

Our Tender Watcher, Susanne Woodman, has two more before we break for the holiday season–which may make your 2018 brighter!

Oxfordshire County Council: This is for a comprehensive telecare service for call monitoring of telecare alarms, a 24/7 emergency response service for telecare alarms, plus the installation, assessment and review of telecare and associated equipment. The Service Provider(s) will work closely with the Equipment Service Provider. This starts in April 2018 for five years with option to extend for two; value not correctly posted (£1?). Closing 15 January 2018.Gov.UK

Housing and Care 21: This is an open future opportunity for providers to indicate interest in providing a new warden call supplier to maintain the existing stock of warden call products across the estate. The contract will be for one to five years with funding of £500k per year. This includes bridging equipment from analogue to digital. The approach to market date is 9 April 2018 with a start date of 1 July. More information at Gov.UK.

Our definitions

Telehealth and Telecare Aware posts pointers to a broad range of news items. Authors of those items often use terms 'telecare' and telehealth' in inventive and idiosyncratic ways. Telecare Aware's editors can generally live with that variation. However, when we use these terms we usually mean:

• Telecare: from simple personal alarms (AKA pendant/panic/medical/social alarms, PERS, and so on) through to smart homes that focus on alerts for risk including, for example: falls; smoke; changes in daily activity patterns and 'wandering'. Telecare may also be used to confirm that someone is safe and to prompt them to take medication. The alert generates an appropriate response to the situation allowing someone to live more independently and confidently in their own home for longer.

• Telehealth: as in remote vital signs monitoring. Vital signs of patients with long term conditions are measured daily by devices at home and the data sent to a monitoring centre for response by a nurse or doctor if they fall outside predetermined norms. Telehealth has been shown to replace routine trips for check-ups; to speed interventions when health deteriorates, and to reduce stress by educating patients about their condition.

Telecare Aware's editors concentrate on what we perceive to be significant events and technological and other developments in telecare and telehealth. We make no apology for being independent and opinionated or for trying to be interesting rather than comprehensive.